title: Role evolution of the mental health clinical nurse specialist in home care.
abstract: With the aging of our population and shortened periods of hospitalization, increasing numbers of people are attempting to manage complex health recovery protocols at home. Not only are these adults at greater risk for health complications, but many have lost significant social supports and have diminished coping abilities. Few home healthcare agencies, however, provide mental health services. The investigator reviewed 150 charts and clinical nurse specialist (CNS) consultation request forms at a large home healthcare agency to analyze the practice of the mental health CNS. First, a comparison between assessment concerns of the home care nurse and the CNS revealed a variance in focus and offers support for Benner's (1984) model of differentiation of practice. Second, the psychosocial assessments by the CNS do not reflect as great a level of severity of illness as the home care nurse-identified behaviors. Finally, the nursing implications for in-service and family education include seminars on adjusting to change, the grieving process, medication education, the importance of opportunities for ventilation and social support, and developing collaborative nurse-patient relationships.
authors.affiliation: Undergraduate Department, Seton Hall University, USA.
authors.forename: G H
authors.initials: GH
authors.lastname: Iglesias
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003152:Community Health Nursing / Q000458:organization & administration*; D005260:Female; D006699:Home Care Services; D006801:Humans; D007587:Job Description; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009720:Nurse Clinicians / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D011568:Psychiatric Nursing / Q000458:organization & administration*; D012189:Retrospective Studies